title: Disclosing a diagnosis of cancer: considerations specific to gynecologic oncology patients.
abstract: OBJECTIVE
  To characterize gynecologic oncology patients' perceptions of the process of disclosure of a cancer diagnosis.
  
  
  METHODS
  We surveyed 100 gynecologic oncology patients between December 2011 and September 2012. An 83-item tool based on three validated assessment tools evaluated patient-centered factors, physician behavior and communication skills, and environmental factors. Associations between patients' satisfaction and these variables were analyzed using Wilcoxon rank-sum, Kruskal-Wallis, and Spearman's rho tests. Poisson regression was used to assess factors associated with patient's satisfaction.
  
  
  RESULTS
  Twenty-four percent of patients were notified of their diagnosis by phone, 60% in the physician's office, and 16% in the hospital. Disclosure was performed by an obstetrician-gynecologist (58%), gynecologic oncologist (26%), primary care physician (8%), or other (8%). Fifty-two percent of all patients were accompanied by a support person. Higher patient satisfaction scores were associated with face-to-face disclosure (mean score 91% compared with over the phone 72%, P=.02), a private setting (mean score 92% compared with impersonal setting 72%, P=.004), and duration of the encounter of greater than 10 minutes (mean score 94% compared with less than 10 minutes 79%, P<.001). Multivariate analysis confirmed that both physician communication skills (P<.001) and patient-centered factors (eg, perception of physician sensitivity and empathy, opportunities to ask questions and express emotion, and set the pace of conversation; P=.013) were associated with higher patient satisfaction.
  
  
  CONCLUSIONS
  Effective physician communication skills and patient-centered factors resulted in higher patient satisfaction with the gynecologic cancer diagnosis disclosure experience.
  
  
  METHODS
  II.
authors.affiliation: Division of Gynecologic Oncology and the Division of Clinical Research, Department of Obstetrics and Gynecology, and the Division of Health Behavior Research, Department of Medicine, Washington University School of Medicine, and the Alvin J. Siteman Cancer Center, St. Louis, Missouri. Dr. Zighelboim's current affiliation: St. Luke's Cancer Care Associates, Temple University School of Medicine, Bethlehem, Pennsylvania.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Kuroki
authors.forename: Qiuhong
authors.initials: Q
authors.lastname: Zhao
authors.forename: Donna B
authors.initials: DB
authors.lastname: Jeffe
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Powell
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Hagemann
authors.forename: Premal H
authors.initials: PH
authors.lastname: Thaker
authors.forename: L Stewart
authors.initials: LS
authors.lastname: Massad
authors.forename: David G
authors.initials: DG
authors.lastname: Mutch
authors.forename: Israel
authors.initials: I
authors.lastname: Zighelboim
mesh_terms: D000368:Aged; D003142:Communication; D003430:Cross-Sectional Studies; D030881:Disclosure / Q000592:standards*; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires